Developing a career in academic paediatrics

Many trainees think about research towards the end of clinical training, but at that stage, it may be too late to get the most from the limited opportunities that remain. Ideally, trainees should consider research early in their career. For some, a career in academic paediatrics may be attractive, in which case following the clinical academic pathway as outlined by the National Institutes of Health Research may be appropriate. For others, research may be part of a wider clinical training. This article discusses a variety of research opportunities available to trainees, and offers advice on a career in academic paediatrics.     

思政元素融入中医基础理论PBL教学模式探析

将思政教育和专业课程学习融合将是今后高校思政教育的潮流和趋势。中医基础理论课程作为中医院校所有专业的必修课及启蒙课,是构筑大学生文化自信的重要途径,是提升大学生专业热情、认知度和满意度的重要桥梁。笔者以PBL教学思想为指导,采用调查问卷、课堂引导、课后访谈、分组研讨、自主学习等方法,对医学院校中的2个非医学(中药与工程)专业的中医基础理论教学进行融入思政元素的实践与探究。在实施过程中,围绕“专业热情”与“科学精神”2个思政元素聚焦点进行引导和沟通。从调查的结果所得的体会是:专业课堂的“隐形思政”功用大有可为;思政元素融入专业课堂需要策略;对专业课堂的思政效果评价要慎重。     

Creating an Academy of Medical Educators: How and Where to Start

Background

While most faculty members want to improve as teachers, they neither know where their educational strengths and weaknesses lie nor where or how to begin to effect a change in their teaching abilities. The lack of actionable, directed and specific feedback, and sensible and sensitive metrics to assess performance and improvement complicates the attainment of educational excellence.

Purpose

The purpose of this article was to outline a series of specific steps that medical education programs can take to enhance the quality of teaching, promote teaching excellence, elevate the status and value of medical educators, and stimulate the creation of innovative teaching programs and curricula.

Methods

To achieve these goals at the Hospital for Special Surgery, the Academy of Rheumatology Medical Educators was formed. The academy had the following goals: (1) create within our institution a mission which advances and supports educators, (2) establish a membership composed of distinguished educators, (3) create a formal organizational structure with designated leadership, (4) dedicate resources that fund mission-related initiatives and research, and (5) establish a plan for promoting teachers as well as enhancing and advancing educational scholarship.

Results

The Hospital for Special Surgery Academy of Rheumatology Medical Educators was recently formed to address these goals by promoting teaching and learning of musculoskeletal skills in an environment that is supportive to educators and trainees and provides much needed resources for teachers.

Summary

The development of a pilot academy of medical educators represents one of the high-priority goals of those institutions that wish to elevate and enrich their teaching through a structured, proven approach.     

舰艇官兵长时间远洋护航内分泌激素变化研究

目的探讨远洋护航舰艇官兵护航前后体内内分泌的变化及可能原因,为制定保障长期远洋护航舰艇官兵身心健康的措施提供依据。方法检测80名舰艇官兵护航前、后及护航结束6个月后体内各项内分泌激素含量,行血清皮质醇(COR)、促卵泡刺激素(FSH)、促黄体生成素(LH)、泌乳素(PRL)、雌二醇(E2)、孕酮(PROG)、睾酮(T)、总甲状腺素(TT4)、总三碘甲状腺原氨酸(TT3)、促甲状腺激素(TSH)、心钠素(ANP)、胃泌素(GAS)、神经降压素(NT)、肾上腺髓质激素(ADM)测定。结果护航后COR、TT3、TT4、TSH、E2、GAS、T、ANP、NT、ADM、PROG、PRL较护航前显著升高(P<0.01),LH、FSH有所降低但差异无统计学意义(P>0.05)。返航6个月与护航前比较,14种内分泌激素差异无统计学意义(P>0.05)。结论长时间护航后,引发舰艇官兵某些内分泌激素指标发生改变,对护航舰艇官兵身心健康有一定程度的影响,但返航6个月后内分泌激素指标恢复正常,不会造成长久的激素紊乱。     

新疆畜牧科学院SCI论文产出分析

以Web of Science检索平台为统计源,对2000-2014年新疆畜牧科学院科研人员在SCI期刊上的论文产出情况进行检索,并对论文数量变化趋势、学科分布、合作机构和国家、论文被引情况及高被引论文等指标进行了系统分析,以期为该院的学科发展、人才建设提供一定的参考依据。     

Consequences of non-medical switch among patients with type 2 diabetes

Objective: This study aimed to describe real-world experiences following a non-medical switch among adults with type 2 diabetes mellitus (T2DM) in the United States.

Methods: For this cross-sectional study, patients with T2DM (N?=?451) provided data on demographics, and how a non-medical switch of their anti-hyperglycemic agent (AHA) affected their general health, HbA1c levels and medication management, via an Internet-based survey. Patients self-reported their level of satisfaction with the original medication and emotional reactions to the non-medical switch. Patients who recently experienced a non-medical switch of their AHA(s) (n?=?379) were asked about the consequences of switching and their satisfaction with the switch (vs. the original) medication.

Results: Patients most frequently reported feeling very/extremely frustrated, surprised, upset and angry in reaction to a non-medical switch. Patients were somewhat satisfied with their original medication. Between 20% and 30% of patients reported the non-medical switch had a moderate/major effect on their general health, diabetes, mental well-being and control over their health. The blood glucose levels of recent switchers were somewhat/much worse (20.7%) and medication management was somewhat/much worse (12.9%) on the switch (vs. the original) medication. Some recent switchers reported old symptoms returning (7.7%) and experiencing new side-effects (14.2%).

Conclusions: Approximately one in five patients reported a moderate/major negative impact on their blood glucose level, diabetes, mental well-being, general health and control over their health following a non-medical switch. Findings suggest that a non-medical switch may have unintended negative health consequences and results in considerable burden across multiple domains for a sizeable minority of patients with T2DM.     

Going to the doctor with enhancement in mind – An ethnographic study of university students’ use of prescription stimulants and their moral ambivalence

Aims: The aim of this qualitative research is to show how the alcohol socialization process – i.e. the ways children and young people get acquainted with alcohol – can generate very diverse experiences and meanings in different cultural contexts.

Method: A total of 16 focus groups were conducted in Italy and Finland, divided by age (4 groups), gender and socio-cultural level. A total of 190 participants took part in the study.

Findings: The findings support the hypothesis that the alcohol socialization process takes place in very different ways and assumes diverse meaning in the two countries involved in the study. In Italy the relationship with alcohol takes place as part of a gradual process and participants’ first memories of drinking alcohol are connected to positive values. In Finland, on the other hand, often the first experiences of drinking overlap with the first experiences of intoxication and alcohol images reflect an ambiguous relation with this substance, closely related to its intoxicating effects.

Conclusions: Results show that the alcohol socialization process can take very different forms and meanings according to a specific drinking cultures. Thus, further comparative research should take into more consideration the implication of these substantial differences.     

A comparison in independent nurse prescribing and patient group directions by nurse practitioners in the emergency department: A cross sectional review

AimTo explore nurse prescribing in an emergency department using patient group directions versus independent nurse prescribing.BackgroundPatient group directions allow restricted access to medication in unselected patients using pre-set criteria. Independent nurse prescribing is a flexible method of medication provision. Limited data exists on the application of either method in clinical practice.MethodsExploration of patient group directions and independent nurse prescribing application in an emergency department using 617 nurse practitioners’ clinical notes; 235 and 382 respectively. Patient attendances from 01/07/2009 to 30/06/2010 were randomly sampled. Prescribing frequency; range of medications and diagnoses; independent episode completion and prescribing safety was explored.ResultsStatistical difference exists in prescribing frequency between the independent nurse prescribers (51.6%, n = 197) and patient group directions (32.3%, n = 76). Appropriate medication given by 99.7% (n = 381) of independent nurse prescribers, with 1 contraindicated drug provided. The limitations of patient group directions was highlighted in 11.8% (n = 9) of cases, however all drugs given were appropriate for the diagnosis. No statistical difference in independent episode completion.ConclusionsNurses provide appropriate medication in an emergency department. Patients being managed by nurse prescribers were more likely to receive medication. Further investigation is required to justify this.     

非医学需要剖宫产和产前负性情绪的关系

目的 探讨非医学需要剖宫产和产前负性情绪的关系.方法 将本院2013年1～8月收治的400例待产妇按照分娩方式分为医学需要剖宫产组、非医学需要剖宫产组及顺产组,对3组孕妇产前焦虑状态进行调查,并对产前负性情绪与非医学需要剖宫产的关系进行Logistic回归分析.结果 非医学与医学需要剖宫产组的状态焦虑评分、特质焦虑评分均显著高于顺产组,差异有统计学意义（P＜0.05）.特质焦虑与状态焦虑是非医学需要剖宫产的独立危险因素（P＜0.05）.结论 产前负性情绪是非医学需要剖宫产的危险因素,应加强待产妇的心理帮助,以减少非医学需要剖宫产的发生.